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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Giant cell arteritis and mortality
R Wade Crow1, Bradley J Katz, Judith E A Warner
1Department of Ophthalmology and Visual Sciences, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA.
Insights
Giant cell arteritis (GCA) significantly increases mortality risk in the first five years post-diagnosis. This study found GCA patients had shorter median survival and lower 5-year survival rates compared to controls.
Area of Science:
- Rheumatology
- Internal Medicine
- Epidemiology
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis affecting the elderly.
- GCA is linked to severe complications like blindness and stroke.
- Previous research on GCA and mortality yielded conflicting results.
Purpose of the Study:
- To investigate the association between Giant cell arteritis (GCA) and increased mortality.
- To compare survival rates of GCA patients with age- and gender-matched controls.
Main Methods:
- A cohort of 44 biopsy-proven Giant cell arteritis (GCA) cases was identified.
- 100 age- and gender-matched controls were selected for each case from the Utah Population Database.
- Median survival time and 5-year cumulative survival were analyzed.
Main Results:
- GCA patients had a median survival of 3.71 years versus 8.34 years for controls (p=0.04).
- Five-year cumulative survival was 35% for GCA cases compared to 67% for controls (p<0.001).
- Survival curves converged around 11.12 years post-diagnosis.
Conclusions:
- Giant cell arteritis (GCA) is associated with a significantly higher risk of mortality within five years of diagnosis.
- Early diagnosis and management of GCA are crucial for improving patient outcomes.
Background:
Giant cell arteritis (GCA) is a systemic vasculitis of elderly individuals associated with significant morbidity, including blindness, stroke, and myocardial infarction. Previous studies have investigated whether GCA is associated with increased mortality, with conflicting results. The objective of this study is to determine whether GCA, is associated with increased mortality.
Methods:
Forty-four cases with GCA were identified from the University of Utah Health Sciences Center, the major tertiary care center for the Intermountain West. The Utah Population Database, a unique biomedical information resource, selected cases and age- and gender-matched controls. Cases were defined as patients with a temporal artery biopsy-proven diagnosis of GCA (international classification of diseases [ICD]-9 code 446.5) between 1991 and 2005. Exclusion criteria included a negative biopsy, alternative diagnoses, or insufficient clinical data. For each of the 44 cases, 100 controls were identified; thus, 4,400 controls were included in the data analysis. Median survival time and 5-year cumulative survival were measured for cases and controls.
Results:
The median survival time for the 44 GCA cases was 1,357 days (3.71 years) after diagnosis compared with 3,044 days (8.34 years) for the 4,400 controls (p = 0.04). Five-year cumulative survival was 67% for the control group versus 35% for the cases (p < .001). Survival rates for cases and controls converged at approximately 11.12 years.
Conclusions:
Patients with GCA were more likely than age- and gender-matched controls to die within the first 5 years following diagnosis.
